Healthcare Provider Details

I. General information

NPI: 1033379086
Provider Name (Legal Business Name): FREEDOM MINISTRIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 W CENTRAL AVE SUITE 108
WICHITA KS
67212-6302
US

IV. Provider business mailing address

2214 N AMARADO CT
WICHITA KS
67205-1508
US

V. Phone/Fax

Practice location:
  • Phone: 316-945-3733
  • Fax:
Mailing address:
  • Phone: 316-945-3733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL MARTIN TRAVER
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 316-945-3733